There is a dogma that states that if the tympanic membrane is opaque, there is a good chance that there is middle ear infection and a myringotomy should be performed to drain and flush the middle ear. Certainly, it is true that 70% of middle ear infections have intact ear drums. However, I regularly see cases where there is an opaque looking ear drum , but the reason the drum is opaque is that is coverered with an adherent “scale” which is composed of a mixture of macerated skin epithelium and ceruminous discharges. This video shows me gently peeling off this “scale”. The video below shows the end result which is a transparent and healthy looking ear drum.
